70. Hypoxies.

Hypoxy or oxygen fasting – typical pathological process occurring due to insufficient tissue consumption with oxygen or as a result of oxygen non-proper usage with cells.

Types:

1. Aethiologically:

1. hypoxic (exogenous): hypobaric and normobaric;

2. respiratory;

3. heart-vascular (circulational);

4. blood (haemic);

5. hypoxy of overload;

6. substrate;

7. tissular (histotoxic).

1. By development time and duration:

1. shark (lightning);

2. acute;

3. subacute;

4. chronic.

1. Dependently on process distribution:

1. local;

2. general.

1. By gravity degree:

1. easy;

2. moderate;

3. grave;

4. critical (death, mortal).

Hypobaric – in highlands in 3500 m (death can be a 8000-8500 m).

Normobaric – at normal total barometric pressure but decreased oxygen partial pressure - in closed small rooms, flying objectives, submarines, some problems with narcosis-respiratory devices.

Respiratory – due to gas exchange insufficiency in lungs.

Circulatory – at massive bleeding, organism dehydration, glucocorticoid insufficiency, allergy processes, electrolyte metabolism problems, toxic influences on vessels and other reasons leading to organs and tissues insufficient blood supply.

Haemic – occurs at effective oxygen blood capacity decreasing at anaemias, hydremias as well as haemoglobine ability changing to bind, transport and give oxygen to tissues.

Tissular or primarily-tissular – due to cells disability to absorb oxygen or as a result of biological oxidation efficacy diminishing because of oxidation and phosphorylation dissemination.

Substarate – due to oxygen insufficient transport or its utilization disturbances.

71. Appetite disturbance.

Anorexy – appetite complete absence at objective needs in food:

1. intoxicational – at acute and chronic intoxications (Hg salts, medicines, bacterial toxins);

2. dyspeptic – at alimentary organs pathology, it has conditionally-reflectory nature;

3. neurodynamic – as a result of reciprocal (parallel) inhibiting of appetite center at limbic system separate structures overexcitement (pain syndrome at myocardial infarction, colicks, peritonitis);

4. neurotic – due to brain hemisphere excessive excitement and strong emotions (especially negative ones);

5. psychogenic – is a result of conscious limiting in eating for being thin or as a result of obsessive idea at psychopathies;

6. neuroendocrinopathic – is determined by organic problems in hypothalamus and endocrine diseases (hypophyseal cachexy, Addissonic disease).

2 Main mechanisms:

1. alimentary center excitability diminishing – intoxicational, dyspeptic, neuroendocrinologic;

2. alimentary center neurons inhibiting – neurodynamic, neurotic, psychogenic.

Hyperorexy or bulimy (at disorder border extent) (from “orexis” – appetite, “bus” – ox, bull, “limos” – hunger) – is accompanied by polyphagy (“polys” – many, “phagein” – to eat) and satiation feeling decreasing.

Reasons:

1. hypothalamic disorders – tertiary hyperorexy;

2. hypophyseal dysfunction – secondary;

3. pancreatic insulas problems – primary process.

Results:

1. obesity;

2. diabetes mellitus;

3. atherosclerosis;

4. organism resistance diminishing to infections.

Parorexy – appetite perversion – striving to eat unedible substances (carbon, chalk, lime). It is caused by changings in gustatory analizator peripheral and central parts; often at pregnancy.

Fast satiation – appetite rapid disappearance right after eating start. Reasons: after operations on stomack (postresectional syndrome), at some intoxications (alcohol), at neurotic states.